Ambulatory emergency care

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While access to emergency care has improved considerably in the NHS, further attention is now required to ensure that only those patients who actually require admission to an acute hospital bed are admitted and that their length of stay is commensurate with their acute care needs.

The Directory of Ambulatory Emergency Care for Adults (the Directory) was published in 2007 by the NHS Institute, identifying 49 emergency conditions (e.g. cellulitis) that have the potential to be managed on an ambulatory basis. The underlying principle is that admission to a hospital bed should only take place in the context of an acute illness that requires inpatient care. Ambulatory models create a ‘virtual ward’ of patients only using services which truly add value to their treatment.

The NHS Institute and the NHS South East Coast SHA are working over a 12 month period to test the implementation of the Directory in several acute sites.

The purpose of this work is to:

  • To implement changes in clinical practice from the Directory of Ambulatory Emergency Care for Adults
  • To achieve the benefits associated with increased ambulatory emergency care:
    • Improved patient experience and outcomes
    • Transformed emergency care processes
    • Released acute care beds
  • To understand the success factors, risks and barriers to implementation

Participating hospitals to date are:

Eastbourne District General Hospital (DGH), East Sussex Hospitals NHS Trust:

  • Eastbourne DGH is working to implement the Respiratory/Leg ‘bundle’ of the Directory, with an initial focus on developing ambulatory pathways for cellulitis and pulmonary embolism (PE) care

Ashford & St. Peter’s NHS Trust:

 

  • St. Peter’s is working to implement the Respiratory/Leg ‘bundle’ of the Directory, with an initial focus on developing ambulatory pathways for community-acquired pneumonia and pulmonary embolism (PE) care

The next phase of the project, starting in spring 2009, will include:

 Medway NHS Foundation Trust
 Frimley Park Hospital NHS Foundation Trust

The learning from NHS South East Coast will then be used to support NHS-wide roll-out of the Directory.

For further information, please contact Sarbjit Purewal at Sarbjit.purewal@institute.nhs.uk

 

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